Over-the-Counter Drug Listing - BenefitAdminSolutions
[Pages:2]Over-the-Counter Drug Listing
Over-the-Counter Drugs Used Primarily for Medical Care. These items are reimbursable with only a thirdparty receipt (the name of the medication and the purchase date must be on the receipt.) No recommendation from a health care provider is required.
Type of Drug
Examples1
Allergy Prevention & Treatment
Benadryl, Sudafed, Actifed, Claritin, Chlora Trimaton, Nasalcrom
Antacids and Acid Reducers
Gas-X, Maalox, Mylanta, Tums, AXID AR, Pepcid AC, Prilosec OTC, Tagamet HB, Zantac 75
Anticandial Antihistamines
Fenstat 3, Gyne-Lotrimin, Mycelrx-7, Monistat 3, 7, Vagistat-1
Actidil Syrup and Capsules, Actifed, Allerest, Benadryl, Claritin, Chlor-Trimeton, Contac, Dimetane, Drixoral, Nyquil, Sudafed, Tavist-1, Triaminic
Antidiarrheal and Laxatives
Ex-Lax, Pepto-Bismol, Immodium A.D., Kaopectate
Anti-fungal
Lamisil AT, Lotramin AF, Micatin
Anti-itch Lotions and Creams (e.g., for athletes foot, Bactine, Caldecort, Cortaid, Hydrocortisone, Lanacort,
jock itch, bug bites, poison ivy)
Calamine Lotion, Benadryl Cream, Caladryl
Asthma
Primatene Mist
Cold Sore/Fever Blister
Abreva Cream, Carmex
Condoms and Other Contraceptive Devices
Trojans, Magnum, VGF Film, Delfen Contraceptive Foam
Contact Lenses Solutions Cough Suppressants
Bausch & Lomb, Renu, Aosept, Allergan, Boston, OptiFree
Robitussin, Vicks 44, Chloraseptic
Decongestant/ Nasal Decongestant and Cold Remedies
Diaper Rash Ointments
Advil Cold and Sinus, Afrin, Afrinol, Aleve Cold and Sinus, Children's Advil Cold, Duration, Dristan Long Lasting, Neo-Synephrine-12 Hour, Orrivin, Pedialyte, Sudafed, Tavist-D, Tylenol Cold and Flu, Thera-flu, Alka Seltzer Cold and Flu
Balmax, Desitin
Eye Drops for Allergy/Cold Relief
Ocu Hist
First Aid Supplies Hemorrhoid Treatments
Ace Bandages, Band-Aids, Bandage Tape, Thermometers, Medical Gloves, Gauze, Neosporin, Rubbing Alcohol, Visine
Preparation H, Hemorid, Tronolane
Internal Analgesic/antipyretic
Incontinence Supplies Liniments
Advil, Aleve, Children's Motrin, Nuprin, Excedrin, Tylenol, Bayer
Depends BenGay, Tiger Balm, Flexall
1 This list is not an exhaustive list and is intended to give examples of some of the most common brand names of OTC drugs.
Anthem Blue Cross and Blue Shield is the trade name of: In Colorado and Nevada: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE? Managed Care, Inc. (RIT), Healthy Alliance? Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia (excluding the City of Fairfax, the Town of Vienna and the area east of State Route 123.): Anthem Health Plans of Virginia, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ? ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.
AT 0039 200909
Medical Monitoring
Services and Bracelets specifically for medical information
Medical Products and Devices
Blood Pressure Monitor, Glucose Tester, HIV Test, Cholesterol Test, Diabetic Supplies, Crutches, Ovulation Monitor, Pregnancy Testing Kits
Menstrual Cycle Medications
Midol, Pamprin, Premysyn PMS
Migraine
Advil Migraine Liqui-gels, Excedrin Migraine, Motrin Migraine Pain
Motion Sickness Medication
Dramamine, Marizine
Nicotine Gum / Patches and Smoking Cessation Aids
Commit, Nicoderm CQ, Nicorette, Nicotrol, Nicodin
Pediculicide (head lice)
Nix
Poison Ivy Protection
Ivy Block
Sleep Aids
Tylenol Simply Sleep, Unisom Sleep Tabs, Sominex, Sleepinal
Toothache and Teething Pain Relievers
Orajel
Wart Removal Medications
Tinamed
Dual Purpose OTC Drugs. These items require a third-party receipt and a note from the health care provider
listing the diagnosis of the medical condition and the recommendation of the OTC Drug.
Anti-baldness/ hair loss/ hair replacement/ such as Rogaine, but only if to replace hair loss due to a medical condition (e.g. cancer treatment) and not for balding due to age
Fiber supplements such as Benefiber and Metamucil
Glucosamine/Chondrotin for arthritis or other medical condition (not reimbursable if taken for overall joint health)
Herbal supplements used to treat a specific disease such as St. John's Wort for depression Hormone Therapy Drugs Medicated shampoos to treat a specific medical condition like psoriasis (only the amount in excess of the cost of normal shampoo is reimbursable.) No Doz (and other sleep prevention drugs)
Nose strips for proper breathing or other medical conditions
Retin-A and other acne medicines (not reimbursable if used for cosmetic purposes such as wrinkle reduction)
Snoring cessation aids and medications such as Breathe Right Spray, Snorezz
Sunscreen and Sunblock
Vitamins are not an eligible expense, unless prescribed by a physician to treat a specific medical condition. (i.e. Iron to treat, not prevent, anemia; Calcium supplements to treat, not prevent, Osteoporosis). A doctor's note detailing the specific medical condition will be required for reimbursement
Weight loss/dietary supplements must be for a specific medical condition such as obesity OTC Items Not Reimbursable. These items are obtained for cosmetic, personal, or general health purposes and are not reimbursable.
Chapstick Cosmetics Cotton balls Deodorants Face creams, moisturizers, eye creams, and wrinkle reducers
Feminine hygiene products such as tampons and maxi pads
Food items (i.e. Slim Fast)
Hair removal treatments and waxes
Mouth washes, antiseptics and oral anesthetics
Shaving cream and razors Soap Teeth whitening kits and powders Toothpaste Vitamins taken to improve overall health
Anthem Blue Cross and Blue Shield is the trade name of: In Colorado and Nevada: Rocky Mountain Hospital and Medical Service, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE? Managed Care, Inc. (RIT), Healthy Alliance? Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Company. In Virginia (excluding the City of Fairfax, the Town of Vienna and the area east of State Route 123.): Anthem Health Plans of Virginia, Inc. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ? ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.
AT 0039 200909
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